How can a CGM help!?

Am been high (over 200) most of the times, and my A1C going high as well (8.4, 8.6, 9) my Endo wants me to start using a CGM (Which I have an appointment with my educator on this monday 10/19).

Nowadays, I test my BG between 8 to 10 times, including one or two time during my sleep.
I know I need to get exercise and watch my food, but my stress life prevent me from that (Graduate student, Research, Work, Family…etc)

How can a CGM help me??

Thanks for the input in advance

Ahmad - A CGM is nothing more than a tool that one can use to better control blood glucose levels. The most important variable in this equation is the person with diabetes. If that person is motivated to achieve better control then a CGM will go a long way toward delivering it.

Since you mention that you test your BG 8-10 times a day and even interrupt a night’s sleep to test then I believe you are highly motivated to improve your control!

I have found that whenever I follow my blood sugar closely and write it down then my control tends to improve. It is the awareness of my current blood sugar situation that engages me to to take action to influence the direction of my BGs.

The difference between finger-stick BG “snapshots” and the real-time full motion movie produced by a CGM is huge. CGMs add a critical dimension to BG monitoring: trends. This makes all the difference in the world. If you do a finger-stick BG before bed and read 120, you may conclude that you’re in good shape. But what if you knew that your BG was actually falling 2 mg/dl/minute? With that trend going on then you could be in hypoglycemia a half hour after falling asleep.

The other very important feature that a CGM contains is the ability to warn you of a steep rise or a steep fall as well as high or low levels. It’s nice to get a heads-up when your BG, currently at 90, is falling 3 mg/dl/minute. It gives you time to take action. Most people are easily distracted by life’s activities (as a graduate student you are preoccupied by a myriad of things, things that give meaning to your life and are important to you).

No one wants to be a “professional diabetic.” However, paying closer attention to your BGs using a continuous glucose monitor will give you the freedom to pursue important work without endangering your basic health. It’s counter-intuitive; the more you pay attention, the more freedom you gain.

Sorry for the long post. In short, I believe that you are an excellent candidate for a CGM and will most likely receive many benefits from it. I say, “Go for it!”

By the way, since I started on the Dexcom 7+ system, I have virtually eliminated lows below 55 and have been warned of every excursion below 80 so that I could take effective counter action at the right time. I’ve also markedly reduced the variability of my BGs. The data management system (I download the CGM data to a netbook computer.) I use reports to me a standard deviation number that tells me how variable my BGs have been.

Good luck.

Great feedback, Terry.

I, too, have eliminated most lows below 60 and most highs above 200 for the last year on my Freestyle Navigator. The fact that I am notified (via beep and trending arrows) as to where I’m headed and how quickly helps me make decisions about dosing or treating before I reach those extremes. I can feel fine, but see I’m 79 and dropping, pop a couple glucose tabs, and head back up to the high 90s, sparing myself a low. I was testing as often as you, Ahmad, but it would have taken testing twice as often to know which direction I was headed in each time.

I haven’t seen a huge change in my A1c (was 6.1 when I started, am 5.6 now), but I have seen a HUGE change in both my range and my standard deviation of blood sugar values, which has helped me level out and feel better without as many wild swings.

Like Terry said, it is a valuable tool in the hands of someone motivated to see improvement, but also someone who is comfortable with that much data coming in at once. I’ve talked to so many people who feel it’s just too much information, but then so many others who consider it an invaluable piece of technology in their arsenal (I’m definitely in that category).

It was enlightening for me hanging out at the TCOYD convention in northern California earlier this month. I’d never been around others on CGMs before. It gave me a strange sense of comfort/validation to see that both Dr. Edelman and Manny checked their Dexcoms as often as I check my Navigator receiver.

Melissa – You’re right. Highly variable BG does take its toll on your energy and how you feel. Reducing that variability is a definite plus. I wouldn’t discount your improvement from 6.1% to 5.6%. That’s over an 8% drop! That brings you down from a mean BG of 139 down to 121. I think your body notices that positive change.

I had a ticket to that TCOYD event in Santa Clara but couldn’t make it. I’ve gone to events like that at the University of California in San Francisco. It’s great to meet face to face with others in your situation and hear about all the latest in diabetes research and treatments.

I’ve only had my Dexcom since September 4th. I’m constantly checking out each new number as it posts. As you say, it’s so much easier to prevent a low than it is to treat one.

I don’t mind the “flood of data” one bit. I feel like for the first time in my 25 years as a diabetic, I am no longer blind to my metabolic direction. This is truly break-through technology. And it will only get better!

Thanks for the feedback Terry and Melissa, you really helped me and am looking forward in enhancing my BGs. Since now I have too many highs and my body is feeling week cause of that! Pain in legs, arms, eyes in general as well!!

Now am sure the CGM will help me in managing my D better in my stressful life!!

Oh Bummer! They hocked me with a CGMS iPro, which I need to wear for 3 days and then return it!! NO CGM for me! :frowning:

The D educator told me that “the insurance will cover it only if you are not aware of lows!” She did ask me if am aware of lows or no and I did say YES. But now wearing the iPro and thinking about if I have awareness or no, am wondering?

Now am 72 mg/dl and feeling high!!! CONFUSING>!?

Clarify that answer of Yes with "Yes,but only sometimes. Not while I am sleeping and not when I am sitting down. I misunderstood your question to mean “Do I EVER feel my lows’” I think you really need the cgms to help you; persistent highs are danagerous as well as persistent lows. Hypoglycemic unawareness and lows while sleeping are a few grounds; there are others. And I doubt if most diabetics can detect a low while asleep, which is the most dangerous time period.

Actually, Jan, though nocturnal lows are dangerous for diabetics, many (like myself) do wake when low. Others actually experience a glycogen dump from their liver that causes them to wake.

Ahmad, while your CDE is speaking from experience, that’s not the ONLY way you can get approval for a CGMS from insurance - especially since April of '09 when companies began approving more often based on released studies. I am not hypoglycemic unaware, but my insurance approved it. Almost every insurer would rather cover a 72 hour diagnostic trial to get your basals set, but they all list stipulations by which they will insure and approve long-term use. Some of these are: if you experience lows below 50 and highs above 150 with frequency (that’s often for you and your insurer to battle out, but I experienced lows below 50 anywhere from 5-7 times per month and that was enough for my insurer). Some insurers want you to be on a pump already, or have a certain A1c, or test a certain number of times per day. I suggest you check your insurer’s medical policy and see how you can qualify. I have found several medical policies online. Here is an example of a plan I was on that approved it last year: Anthem BCBS DME policy for Glucose Monitoring (see Section II - interstitial). I’m on a different plan now, but the stipulations are similar.

I said I was hypo unaware when I applied for mine (I am), as well as having a very strong DP, but my insurance also wanted logs from the past 60 days (and mine showed plenty of lows) as well as all of my clinical notes from my endo’s office before they approved me. Humana’s policies on paper are very similar to what you linked, but like pumps, I think it’s clearly a case by case approval. I had no trouble getting mine approved though - once Dexcom submitted the order to my insurance (which took FOREVER), it took about a week to get approved, and that included my insurance requesting additional information from my endo.